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在医疗病房中治疗“不健康饮酒者”:超越戒断治疗。

Treating the "unhealthy alcohol user" on medical wards: beyond withdrawal.

作者信息

Rivest Jacynthe, Jutras-Aswad Didier, Shapiro Peter A

机构信息

Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA.

出版信息

J Psychiatr Pract. 2013 May;19(3):213-26. doi: 10.1097/01.pra.0000430505.52391.48.

Abstract

BACKGROUND

Alcohol use disorders (AUDs) are common among patients admitted to general hospitals. Unfortunately, AUDs often go undetected and untreated. Psychiatrists are frequently called upon to assist in the management of cases involving alcohol withdrawal. However, there is a dearth of knowledge regarding potential therapeutic approaches to AUDs beyond the acute withdrawal stage.

OBJECTIVE

This article presents an overview of the epidemiology, clinical characteristics, and treatment of AUDs on medical wards, with a specific focus on the post alcohol-withdrawal phase.

METHOD

This article is based on a survey of the published literature on AUDs and their treatment in the medical ward using the PubMed database.

RESULTS

Various screening tools are available to facilitate the detection of AUDs. Among non-medically ill patients, brief psychological interventions have proven to be effective in primary care and emergency room settings, while pharmacotherapy has been shown to reduce the risk of relapse. Existing data on the implementation of these interventions in the general hospital setting remain scarce.

CONCLUSION

Current evidence suggests the need for additional research in this area with a view toward clarifying AUD treatment guidelines for medically ill inpatients. The hospital stay could provide a valuable opportunity to initiate interventions for AUDs with medically ill patients, leading to significant changes in alcohol use behaviors and better health-related outcomes.

摘要

背景

酒精使用障碍(AUDs)在综合医院收治的患者中很常见。不幸的是,AUDs常常未被发现和治疗。精神科医生经常被要求协助处理涉及酒精戒断的病例。然而,对于AUDs在急性戒断期之后的潜在治疗方法,人们知之甚少。

目的

本文概述了内科病房中AUDs的流行病学、临床特征及治疗方法,特别关注酒精戒断后阶段。

方法

本文基于使用PubMed数据库对已发表的关于内科病房中AUDs及其治疗的文献进行的一项调查。

结果

有多种筛查工具可用于促进对AUDs的检测。在非内科疾病患者中,简短心理干预已被证明在初级保健和急诊室环境中有效,而药物治疗已显示可降低复发风险。关于在综合医院环境中实施这些干预措施的现有数据仍然很少。

结论

目前的证据表明,有必要在该领域开展更多研究,以明确内科住院患者的AUD治疗指南。住院期间可为内科疾病患者启动AUDs干预提供宝贵机会,从而导致饮酒行为发生重大改变并带来更好的健康相关结果。

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